血糖控制不佳:刚果民主共和国金沙萨 2 型糖尿病患者的患病率、患病因素及其对护理工作的影响:一项横断面研究。

Frontiers in clinical diabetes and healthcare Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI:10.3389/fcdhc.2023.1241882
Jean-Pierre Fina Lubaki, Olufemi Babatunde Omole, Joel Msafiri Francis
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引用次数: 0

摘要

导言:糖尿病是撒哈拉以南非洲地区的一个重大问题,如何控制血糖是 2 型糖尿病患者面临的一项健康挑战。刚果民主共和国金沙萨的血糖控制数据有限。本研究评估了血糖控制的患病率和相关因素,为改善金沙萨血糖控制的潜在干预措施提供信息:这是一项横断面研究,研究时间为 2021 年 11 月至 2022 年 9 月,研究对象是从金沙萨随机抽取的 20 家医疗机构招募的患者。参与者需填写一份结构化问卷,并提供两毫升血液用于 Hb1AC 检测。血糖控制不佳的定义是 HbA1c ≥7%。为确定与血糖控制不良相关的因素,进行了单变量和多变量逻辑回归:本研究共招募了 620 名参与者。研究参与者的中位年龄为 60 岁(IQR=53.5-69),大多数为女性(66.1%),失业(67.8%),收入低于贫困线(76.4%),没有医疗保险(92.1%)。约三分之二的参与者(420 人;67.6%)血糖控制不佳。接受胰岛素单药治疗(AOR=1.64,95%CI [1.10-2.45])和治疗时间≥7 年(AOR=1.45,95%CI [1.01-2.08])的参与者血糖控制不佳的几率增加,而超重(AOR=0.47,95%CI [0.26-0.85])和血压未得到控制(AOR=0.65,95%CI [0.48-0.90])的参与者血糖控制不佳的几率降低:结论:刚果民主共和国金沙萨的 2 型糖尿病患者普遍存在血糖控制不佳的情况。仅使用胰岛素和糖尿病治疗时间等于或超过 7 年,容易导致血糖控制不佳。相反,血压失控和体重超重则对血糖控制不良有保护作用。血压失控和超重与血糖控制之间的这种联系并不常见。这主要反映了撒哈拉以南非洲地区糖尿病的特殊性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Poor glycaemic control: prevalence, factors and implications for the care of patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.

Introduction: Diabetes is a significant problem in sub-Saharan Africa and achieving glycaemic control poses a health challenge among patients living with type 2 diabetes. There are limited data on glycaemic control in Kinshasa, Democratic Republic of the Congo. This study assessed the prevalence and factors associated with glycaemic control to inform potential interventions to improve glycaemic control in Kinshasa.

Methods: This was a cross-sectional study conducted between November 2021-September 2022 among patients recruited from 20 randomly selected health facilities in Kinshasa. Participants were asked to complete a structured questionnaire and to provide two millilitres of blood for Hb1AC assay. Poor glycaemic control was defined as HbA1c ≥7%. Univariate and multivariable logistic regressions were performed to identify factors associated with poor glycaemic control.

Results: A total of 620 participants were recruited for this study. Study participants had a median age of 60 (IQR=53.5-69) years with the majority being female (66.1%), unemployed (67.8%), having income below the poverty line (76.4%), and without health insurance (92.1%). About two-thirds of the participants (420; 67.6%) had poor glycaemic control. Participants on monotherapy with insulin (AOR=1.64, 95%CI [1.10-2.45]) and those on a treatment duration ≥7 years (AOR=1.45, 95%CI [1.01-2.08]) were associated with increased odds of poor glycaemic control while being overweight (AOR= 0.47, 95%CI [0.26-0.85]) and those with uncontrolled blood pressure (AOR=0.65, 95% CI [0.48-0.90]) were protective for poor glycaemic control.

Conclusion: Poor glycaemic control is prevalent among patients with type 2 diabetes in Kinshasa, DRC. Being on insulin alone and a duration of diabetes treatment equal or more than 7 years predisposed to poor glycaemic control. By contrary, having uncontrolled blood pressure and being overweight had protective effect against poor glycaemic control. These links between uncontrolled blood pressure and overweight on the one hand, and glycaemic control on the other are unusual. These reflect, among other things, the specific characteristics of diabetes in sub Saharan Africa.

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